Telephone Counseling - Caregivers for Children with Cancer

电话咨询 - 癌症儿童的护理人员

• 批准号: 8339427
• 负责人: Debra L. Friedman
• 金额: $ 20.88万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-27 至 2014-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8339427
• 关键词: Address; Anxiety; Area; Attention; Behavioral Research; Cancer Center; Cancer Control; Cancer Survivorship; Caregivers; Caring; Child; Chronic; Communication; Coping Skills; Counseling; Data; Development; Diagnosis; Distress; Educational Materials; Educational process of instructing; Enrollment; Family; Family member; Feasibility Studies; Feeling; Funding; Future; Goals; Grant; Health; Household; Institution; Intervention; Intervention Studies; Intervention Trial; Interview; Left; Life; Long Term Survivorship; Malignant Childhood Neoplasm; Malignant Neoplasms; Measures; Mediator of activation protein; Mental Depression; NIH Program Announcements; National Cancer Institute; Needs Assessment; Occupations; Outcome; Parents; Participant; Pathway interactions; Patients; Pediatric Oncology; Personal Satisfaction; Pilot Projects; Program Evaluation; Psychiatric Social Work; Randomized; Research; Risk; Sampling; Self Efficacy; Sensory; Services; Stress; Survival Rate; Survivors; Symptoms; Targeted Research; Telephone; Testing; Time; Treatment Efficacy; Trust; Uncertainty; Work; base; cancer care; cancer diagnosis; cancer risk; cancer therapy; caregiving; childhood cancer survivor; clinical efficacy; clinically significant; cohort; coping; design; disturbance in affect; efficacy testing; efficacy trial; experience; follow-up; improved; innovation; neglect; oncology; parental role; programs; psychoeducational intervention; psychosocial; randomized trial; research study; response; satisfaction; stressor; theories; treatment as usual; treatment duration

DESCRIPTION (provided by applicant): The rate of survival for childhood cancer continues to improve and now approaches 80%. Coincident with this survival are adverse long-term health-related outcomes for survivors and their family members. Throughout the cancer care continuum, from time of diagnosis through long-term survivorship, children and their families are confronted with multiple and pervasive stressors, including uncertainty about the chance of survival, treatment- related adverse health effects, disruption in daily activities and disruption of the parental role function. This may result in clinically significant global distress, depression, posttraumatic stress (PTS) and reduced self-efficacy. Therefore, providing psychosocial services to parents of children with cancer is necessary. Yet, feasible and theory-based psychosocial intervention studies are extremely limited, particularly at the completion of the child's cancer treatment, a time known to be anxiety-provoking and often characterized by feelings of abandonment and uncertainty about the future. Barriers to participation in face-to-face interventions at the treating institution include the considerable distance that many families live from the institution, difficulty leaving children, households or jobs and potential for sensory and interpersonal experiences at the treating institution to trigger symptoms of anxiety and PTS. In response to these concerns, we are proposing to extend the reach of essential psychosocial counseling services to primary caregivers of children with cancer by designing and implementing a small-scale feasibility pilot of an innovative and highly translatable telephone-based psychosocial intervention. This intervention will be implemented during the transition from primary active oncology treatment to follow-up care, reflecting a neglected area of research. Specifically, we propose to design and then test the feasibility of a two-group randomized trial of a psychosocial telephone counseling program for primary caregivers of children who have completed cancer therapy in the previous year, consisting of an attention control condition (educational materials and outcalls with no counseling) and an experimental condition (telephone counseling plus the educational materials). We will evaluate the proposed telephone counseling intervention for feasibility, satisfaction and perceived helpfulness. The primary endpoints will include psychosocial distress and benefit finding. Furthermore, we will assess and explore the plausible intervention mechanisms and pathways that may explain and elucidate intervention efficacy (mediator variables). The main theory-based mediator variables that will be tested include secondary appraisal (coping self-efficacy) and coping effort. Lastly, based on the preliminary data obtained from this study, we will seek funding to design and implement a larger randomized clinical efficacy trial, whose ultimate goal will be to develop a highly effective and exportable telephone counseling intervention for primary caregivers of children with cancer that could be become an integral component of care given to pediatric oncology patients.

描述（由申请人提供）：儿童癌症的生存率继续提高，现在接近80％。与这种生存相吻合是对幸存者及其家人的不利长期与健康相关的结果。在整个癌症护理连续性中，从诊断到长期生存期，儿童及其家人都面临着多种和普遍的压力源，包括有关生存机会的不确定性，与治疗相关的不良健康影响，日常活动中的破坏以及父母角色的破坏。这可能会导致临床上重要的全球困扰，抑郁症，创伤后压力（PTS）和自我效能感降低。因此，必须为癌症儿童的父母提供社会心理服务。然而，可行且基于理论的社会心理干预研究极为有限，尤其是在儿童癌症治疗的完成时，这是发人深省的时代，通常以对未来的遗弃和不确定性的感觉。参与治疗机构面对面干预措施的障碍包括许多家庭与该机构生活的相当距离，难以离开儿童，家庭或工作，以及在治疗机构的感觉和人际交往经验的潜力，以触发焦虑和PT的症状。为了应对这些问题，我们提议通过设计和实施一个小规模的可行性试验，以创新且高度可翻译的基于电话的心理社会心理干预措施，将基本心理咨询服务的覆盖范围扩展到癌症儿童的主要护理人员。从主要的主动肿瘤治疗到后续护理的过渡期间，将实施这种干预措施，这反映了被忽视的研究领域。具体而言，我们建议设计并测试对上一年完成癌症治疗的儿童的初级护理人员的两组随机试验的可行性，其中包括注意力控制条件（包括教育材料和无咨询服务）和实验性条件（电话辅导以及电话咨询以及教育材料）。我们将评估拟议的电话咨询干预措施，以实现可行性，满意度和可感知的帮助。主要终点将包括社会心理困扰和利益发现。此外，我们将评估和探索可能解释和阐明干预功效的合理干预机制和途径（调解器变量）。将测试的主要基于理论的调解人变量包括次级评估（应对自我效能）和应对工作。最后，根据从这项研究中获得的初步数据，我们将寻求资金来设计和实施一项更大的随机临床疗效试验，其最终目标是为癌症儿童的主要护理人员开发一种高效且可导出的电话咨询干预措施，这些干预者可以成为对儿科癌症学患者的护理组成部分。